Background: Epistaxis is a common medical problem in pediatric population. Although in most cases it is mild and self-limiting, a proportion of childhood epistaxis is massive, recurrent, or resistant to conventional management. Objective: To compare effectiveness of propranolol as a treatment option for childhood epistaxis versus conventional silver nitrate cautery. Study design and methodology: This is a prospective interventional comparative study that was carried out during a period of 1 year (January 1, 2013 to December 31, 2013) at Qena University Hospital and Assiut University Children Hospital. One hundred children aged 6–12 years who presented with epistaxis to Qena University Hospital and Assiut University Children Hospital during the study period and fulfilling the inclusion criteria were included in the study. They were randomly assigned into one of two interventional groups, where 50 children were treated with oral propranolol (propranolol treatment group) and another 50 children were treated with conventional silver nitrate cautery (cauterization treatment group) for their epistaxis. Propranolol was given at a dose of 1.5–2 mg/kg/day (divided into three doses). Patients were followed for 6 months after their discharge for recurrence of epistaxis. Results: Both groups of patients showed minimal recurrent epistaxis with rates of 14% for propranolol treated group and 12% for cauterization group, with no statistically significant difference between both groups. Local pain was found to be more in patients treated with silver nitrate cauterization. Conclusion: Treatment of primary epistaxis with propranolol or silver nitrate cautery showed equal rates of recurrence, and local nasal pain was slightly more among silver nitrate cauterization treated group. Propranolol could be a favorable treatment option for patients with primary epistaxis. Further studies that include multiple centers and larger number of patients are recommended for more clarification of the effectiveness of such treatment option.

NULLAbstract Background: Egypt is considered a region of the intermediate prevalence of hepatitis B virus (HBV) infection (4.5%). Seroprotection is assured when hepatitis B surface antibody (HBsAb) levels are ≥ 10 mIU/ mL. Our study aimed to evaluate and compare the long-term immunogenicity and efficacy of the recombinant hepatitis B (HB) vaccine. Methods: A cross-sectional study was done for children aged from 9 months to 15 years, receiving health care at Assiut University Children’s Hospital, Assiut, Egypt in 3 months. HBsAb was quantitatively determined by enzyme-linked immune sorbent assay (ELISA). Results: Seroprotection in infants less than 1 year was 89.7% with 55.2% having titer > 100 mIU/mL and this percent dropped to 64.4% after the first year of age with only 29% having titer > 100 mIU/ mL. The overall protection percentage was 32.5% (> 100 mIU/mL), 34.7% of children showed levels between 10 and 100 mIU/mL, while 32.8% were less than 10 mIU/mL. Patients with diabetes mellitus were found to have the lowest seroprotective levels (83.3% were not protected). Non-protective levels were also detected in patients with malnutrition (55.6%), congenital heart diseases (43.2%) and chronic liver diseases (57.1%). Conclusion: Our study shows failure to achieve satisfactory seroprotective levels for hepatitis B vaccine in both healthy and diseased children who adopted vaccination schedule in Upper Egypt. Booster dose in the second year of life is recommended for all children, particularly for those with diabetes millets, congenital heart disease and malnutrition. Keywords: Immunogenicity; Hepatitis B vaccine; Children

NULLAbstract Background: Egypt is considered a region of the intermediate prevalence of hepatitis B virus (HBV) infection (4.5%). Seroprotection is assured when hepatitis B surface antibody (HBsAb) levels are ≥ 10 mIU/ mL. Our study aimed to evaluate and compare the long-term immunogenicity and efficacy of the recombinant hepatitis B (HB) vaccine. Methods: A cross-sectional study was done for children aged from 9 months to 15 years, receiving health care at Assiut University Children’s Hospital, Assiut, Egypt in 3 months. HBsAb was quantitatively determined by enzyme-linked immune sorbent assay (ELISA). Results: Seroprotection in infants less than 1 year was 89.7% with 55.2% having titer > 100 mIU/mL and this percent dropped to 64.4% after the first year of age with only 29% having titer > 100 mIU/ mL. The overall protection percentage was 32.5% (> 100 mIU/mL), 34.7% of children showed levels between 10 and 100 mIU/mL, while 32.8% were less than 10 mIU/mL. Patients with diabetes mellitus were found to have the lowest seroprotective levels (83.3% were not protected). Non-protective levels were also detected in patients with malnutrition (55.6%), congenital heart diseases (43.2%) and chronic liver diseases (57.1%). Conclusion: Our study shows failure to achieve satisfactory seroprotective levels for hepatitis B vaccine in both healthy and diseased children who adopted vaccination schedule in Upper Egypt. Booster dose in the second year of life is recommended for all children, particularly for those with diabetes millets, congenital heart disease and malnutrition. Keywords: Immunogenicity; Hepatitis B vaccine; Children

NULLAbstract Background: Egypt is considered a region of the intermediate prevalence of hepatitis B virus (HBV) infection (4.5%). Seroprotection is assured when hepatitis B surface antibody (HBsAb) levels are ≥ 10 mIU/ mL. Our study aimed to evaluate and compare the long-term immunogenicity and efficacy of the recombinant hepatitis B (HB) vaccine. Methods: A cross-sectional study was done for children aged from 9 months to 15 years, receiving health care at Assiut University Children’s Hospital, Assiut, Egypt in 3 months. HBsAb was quantitatively determined by enzyme-linked immune sorbent assay (ELISA). Results: Seroprotection in infants less than 1 year was 89.7% with 55.2% having titer > 100 mIU/mL and this percent dropped to 64.4% after the first year of age with only 29% having titer > 100 mIU/ mL. The overall protection percentage was 32.5% (> 100 mIU/mL), 34.7% of children showed levels between 10 and 100 mIU/mL, while 32.8% were less than 10 mIU/mL. Patients with diabetes mellitus were found to have the lowest seroprotective levels (83.3% were not protected). Non-protective levels were also detected in patients with malnutrition (55.6%), congenital heart diseases (43.2%) and chronic liver diseases (57.1%). Conclusion: Our study shows failure to achieve satisfactory seroprotective levels for hepatitis B vaccine in both healthy and diseased children who adopted vaccination schedule in Upper Egypt. Booster dose in the second year of life is recommended for all children, particularly for those with diabetes millets, congenital heart disease and malnutrition. Keywords: Immunogenicity; Hepatitis B vaccine; Children

NULLAbstract Background: Egypt is considered a region of the intermediate prevalence of hepatitis B virus (HBV) infection (4.5%). Seroprotection is assured when hepatitis B surface antibody (HBsAb) levels are ≥ 10 mIU/ mL. Our study aimed to evaluate and compare the long-term immunogenicity and efficacy of the recombinant hepatitis B (HB) vaccine. Methods: A cross-sectional study was done for children aged from 9 months to 15 years, receiving health care at Assiut University Children’s Hospital, Assiut, Egypt in 3 months. HBsAb was quantitatively determined by enzyme-linked immune sorbent assay (ELISA). Results: Seroprotection in infants less than 1 year was 89.7% with 55.2% having titer > 100 mIU/mL and this percent dropped to 64.4% after the first year of age with only 29% having titer > 100 mIU/ mL. The overall protection percentage was 32.5% (> 100 mIU/mL), 34.7% of children showed levels between 10 and 100 mIU/mL, while 32.8% were less than 10 mIU/mL. Patients with diabetes mellitus were found to have the lowest seroprotective levels (83.3% were not protected). Non-protective levels were also detected in patients with malnutrition (55.6%), congenital heart diseases (43.2%) and chronic liver diseases (57.1%). Conclusion: Our study shows failure to achieve satisfactory seroprotective levels for hepatitis B vaccine in both healthy and diseased children who adopted vaccination schedule in Upper Egypt. Booster dose in the second year of life is recommended for all children, particularly for those with diabetes millets, congenital heart disease and malnutrition. Keywords: Immunogenicity; Hepatitis B vaccine; Children

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